Core components and impact of nurse-led integrated care models for home-dwelling older people: A systematic review and meta-analysis

Laurent, Gwen; Cornelissen, Lonne; Yip, Olivia; Zúñiga, Franziska; Denhaerynck, Kris; Briel, Matthias; Karabegovic, Azra; Geest, Sabina De

doi:10.1016/j.ijnurstu.2020.103552

Cited by 42 publications

(58 citation statements)

References 66 publications

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“…Implementing integrated care services is rather challenging because they frequently include many intervention components, target several outcomes and occur at various system levels [ 10 , 11 ]. While they often involve different types of health professionals, policy makers and other stakeholders, the end-users are often overseen, despite the strong promotion of involving them in the design, delivery and implementation of integrated service research [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

The INSPIRE Population Survey: development, dissemination and respondent characteristics

Siqeca

Obas

Yip

et al. 2021

BMC Med Res Methodol

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Background Most older adults prefer to continue living at home despite increasing care needs and demand for services. To aid in maintaining independence, integrated care models for community-dwelling older people are promoted as the most cost-effective approach. The implementation of such care models is challenging and often the end-users are not involved or their needs are not considered. We conducted a population survey in order to understand the needs and preferences of home-dwelling older adults living in Canton Basel-Landschaft, Switzerland. The aims of this paper are to chronicle the development of the INSPIRE Population Survey, outline its variables and measurements, describe the marketing strategy utilized for survey dissemination and report on the response rate and respondent characteristics. Methods The INSPIRE Population Survey, conducted between March and August 2019, is a cross-sectional survey of older adults aged 75 and older living at home in Canton Basel-Landschaft. The questionnaire was developed by expert input and stakeholder involvement. Its readability and acceptability were pilot-tested with older people. To ensure the likelihood of a high and representative response rate, a meticulous step-by-step marketing strategy was developed prior to the dissemination of the questionnaire. Results The overall response rate was 30.7% (n = 8,846), with variations between 20.6 and 34.5% across the different care regions in the canton. A generally higher response rate was found in the care regions with a higher density and which bordered the urban city of Basel. We received support from local stakeholders, policy makers and media through using a broad combination of marketing channels and targeting our community partners who have a strong relationship with our target audience. Conclusions Although recruiting older adults in research is challenging, our study shows that a high response rate can be achieved by developing the survey through expert input and by involving all important stakeholders, including older adults, throughout the entire process.

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Section: Introductionmentioning

confidence: 99%

The INSPIRE Population Survey: development, dissemination and respondent characteristics

Siqeca

Obas

Yip

et al. 2021

BMC Med Res Methodol

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“…Barriers related to information systems, such as lack of a shared electronic medical record, impedes information exchange between health care providers in different settings, which can result in challenges to care co-ordination and negative impacts on patient experiences (Kripalani et al , 2007; Coleman, 2003; Kiran et al , 2020). Integrated care models that are guided by a lead co-ordinator to support care co-ordination can improve communications amongst a multidisciplinary team and continuity of care (Wheatley et al , 2017; Deschodt et al , 2020)…”

Section: Introductionmentioning

confidence: 99%

Health care providers' experiences with delivering person centred care in an Integrated Care Program for thoracic surgery patients in Ontario, Canada

Kornas

O’Neill

Liang

et al. 2021

JICA

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PurposeThe purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.Design/methodology/approachThe authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.FindingsThe IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.Originality/valueThis study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.

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“…Integrated care interventions are often multifactorial and complex, which can take place across multiple levels. These are the macro level of health systems that enhance collaboration between health organizations, the meso level of health professionals that facilitates multi-disciplinary team in delivery of care services, and the micro level of individuals that promotes multi-component self-care (14,15). Despite the importance of implementing multi-level and multi-component interventions, actual practices are often limited across these three levels leading to suboptimal integration of health services, poor health outcomes and unsatisfactory patient experiences (13,16).…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Person-centred Integrated Care for Community-dwelling People With Hypertension and Diabetes in High-income Countries: Protocol for a Systematic Review and Meta-analysis

Xiao

Hyun

et al. 2021

Preprint

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Background: Hypertension and diabetes are two of the high prevalent non-communicable diseases. Inadequate care coordination among health systems and between health professionals as well as limited self-care capability of patients lead to the suboptimal care for people with hypertension and diabetes. Person-centred integrated care aiming to address these three levels of barriers has been proposed by World Health Organization as a global strategy to enhance the quality of care for people with chronic diseases. However, the effectiveness and characteristics of integrated care for community-dwelling people with hypertension and diabetes has not been systematically assessed.Methods: A systematic literature search will be conducted in seven databases including MEDLINE, Emcare, CINAHL, EMBASE, Cochrane Library of systematic reviews, Scopus and ProQuest. Additional studies will be identified through manual searching of reference lists and grey literatures. Quantitative studies (e.g. randomized controlled trials, quasi-randomized trials, before-and-after studies) evaluating the effects of integrated care for community-dwelling people with hypertension and diabetes will be included. Primary outcomes will be systolic and diastolic blood pressure. Secondary outcomes will include the proportion of patients achieving target blood pressure, glycated haemoglobin, fasting blood glucose, blood lipid, treatment adherence, health knowledge, mortality, quality of life, hospitalisation, emergency department use, patient satisfaction, adverse events and caregiver burden. Two reviewers will independently screen articles, extract data and assess study quality. Methodological quality of the selected studies will be assessed using the Revised Cochrane risk-of-bias tool and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Disagreements will be resolved through team discussion. Random effects model will be used for data synthesis if feasible.Discussion: This systematic review will summarise the evidence regarding the overall effectiveness, core components and implementation mechanism of integrated care interventions for people with hypertension and diabetes. Findings from the review will provide crucial evidence to inform the development of health policy, clinical practice and health resources to relieve the burden of hypertension and diabetes on healthcare systems.Registration: The protocol is registered with PROSPERO (registration number CRD42021271338)

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Core components and impact of nurse-led integrated care models for home-dwelling older people: A systematic review and meta-analysis

Abstract: Geest S, and the INSPIRE consortium. Core components and impact of nurse-led integrated care models for home-dwelling older adults: a systematic review and metaanalysis.

Cited by 42 publications

References 66 publications

The INSPIRE Population Survey: development, dissemination and respondent characteristics

The INSPIRE Population Survey: development, dissemination and respondent characteristics

Health care providers' experiences with delivering person centred care in an Integrated Care Program for thoracic surgery patients in Ontario, Canada

Effectiveness of Person-centred Integrated Care for Community-dwelling People With Hypertension and Diabetes in High-income Countries: Protocol for a Systematic Review and Meta-analysis

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